Document Detail

Surgically induced necrotizing scleritis after primary pterygium surgery with conjunctival autograft.
MedLine Citation:
PMID:  22140306     Owner:  NLM     Status:  PubMed-not-MEDLINE    
BACKGROUND: Although pterygium excision with conjunctival autograft is a widely performed surgical procedure, surgically induced necrotizing scleritis (SINS) following such surgery is extremely rare.
METHODS: A 68-year-old man underwent nasal pterygium excision with conjunctival autograft uneventfully. On postoperative day 17, the conjunctival graft was avascular, with epithelial defect. Although topical steroid and antibacterial treatments were continued, the graft and sclera melted, with the ischemic sclera showing gradual thinning. The thinning area spread to the adjoining cornea, and active inflammation with epithelial defect was observed adjacent to the site of thinning.
RESULTS: Systemic and microbiological examination was noncontributory. The patient was suspected of having SINS, and administration of oral prednisolone was started. Although the necrotic area was reduced temporarily, medication was discontinued due to nausea, and the area of thinning increased. Conjunctival flap surgery was later performed, and the graft was well accepted.
CONCLUSIONS: SINS must be considered in the differential diagnosis of patients with scleritis following pterygium surgery, especially if radiation or mitomycin C has not been used.
Katsuya Yamazoe; Seika Shimazaki-Den; Isao Otaka; Kazuki Hotta; Jun Shimazaki
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Publication Detail:
Type:  Journal Article     Date:  2011-11-10
Journal Detail:
Title:  Clinical ophthalmology (Auckland, N.Z.)     Volume:  5     ISSN:  1177-5483     ISO Abbreviation:  Clin Ophthalmol     Publication Date:  2011  
Date Detail:
Created Date:  2011-12-05     Completed Date:  2012-10-02     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101321512     Medline TA:  Clin Ophthalmol     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  1609-11     Citation Subset:  -    
Department of Ophthalmology, Tokyo Dental College, Ichikawa.
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